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Whites More Likely to Get ER Narcotics

January 2, 2008 — Dr Esam Omeish

It is my prayer that we can rectify unfair situations like the ones described in this story. It seems that in many ways we are still separate and unequal.

Emergency room doctors are prescribing strong narcotics more often to patients who complain of pain, but minorities are less likely to get them than whites, a new study finds. Even for the severe pain of kidney stones, minorities were prescribed narcotics such as oxycodone and morphine less frequently than whites.

The analysis of more than 150,000 emergency room visits over 13 years found differences in prescribing by race and ethnicity in both urban and rural hospitals, in all U.S. regions and for every type of pain.

“The gaps between whites and nonwhites have not appeared to close at all,” said study co-author Dr. Mark Pletcher of the University of California, San Francisco.

The study appears in Wednesday’s Journal of the American Medical Association. Prescribing narcotics for pain in emergency rooms rose during the study, from 23 percent of those complaining of pain in 1993 to 37 percent in 2005.

The increase coincided with changing attitudes among doctors who now regard pain management as a key to healing. Doctors in accredited hospitals must ask patients about pain, just as they monitor vital signs such as temperature and pulse.

Even with the increase, the racial gap endured. Linda Simoni-Wastila of the University of Maryland, Baltimore, School of Pharmacy said the race gap finding may reveal some doctors’ suspicions that minority patients could be drug abusers lying about pain to get narcotics.

The irony, she said, is that blacks are the least likely group to abuse prescription drugs. Hispanics are becoming as likely as whites to abuse prescription opioids and stimulants, according to her research. She was not involved in the current study.

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In more than 2,000 visits for kidney stones, whites got narcotics 72 percent of the time, Hispanics 68 percent, Asians 67 percent and blacks 56 percent.

The data came from a well-regarded government survey that collects information on emergency room visits for four weeks each year from 500 U.S. hospitals. The new study was funded by federal grants.